Complex Health Needs of Young Migrants from North Africa in an Urban Setting

Background

Across European cities, some adolescent and young adult (AYA) migrants from North Africa (NA) live in extreme precarity and remain outside formal support structures. Despite their visibility in urban spaces, evidence on their health needs is scarce. Understanding their health status is essential for equitable health policies.

Methods

We conducted a two‑year retrospective analysis of electronic medical records from AYA from NA enrolled in a protection programme in Geneva (2019–2021). All hospital consultations-emergency, outpatient, and penitentiary- within two years of registration were reviewed. Health problems were coded using ICPC‑2, and substance use in the previous 30 days was recorded. Descriptive statistics were used to present health problems and substance use, and their association was examined using Generalized Estimating Equations.

Findings

Of 452 registered individuals, 48.5% used health services; most were male and adolescents at first contact. Among service users, 68.9% accessed emergency care, 56.2% outpatient care and 48.4% penitentiary care. Frequent ICPC-2 categories were psychological (63.5%), general (61.6%), skin (57.1%), musculoskeletal (50.7%) and digestive (50.2%). Common specific problems were trauma/injury (58.6%), drug abuse (45.1%), anxiety (38.6%), sleep disturbance (37.7%) and teeth disease (33.5%). Substance use was reported by 73.1%, often involving multiple substances (tobacco, cannabis, pregabalin, benzodiazepines, alcohol). Use was strongly associated with poorer health, with the highest association for psychological problems (OR 24.4, 95% CI 10.6–56.3).

Conclusions

AYA migrants from NA living in urban precarity show high mental health needs, frequent trauma and polysubstance use, reflecting structural vulnerabilities linked to limited protection and fragmented urban service pathways. Integrated, youth‑adapted urban health responses and continuity of support beyond age‑based systems are essential to reduce health inequities.

Key messages

• Young migrants from North Africa living in precarious urban conditions show high mental health needs, trauma and polysubstance use, highlighting urgent gaps in youth-adapted urban health services.

• Fragmented urban health systems fail precarious migrant youth, reinforcing emergency-based care and unmet mental health and substance use needs.